External Data Request Form

Date Data Needed e.g. (xx/xx/xx)*
(*Note: All data requests require at least 10 business days to process. Due to staff capacity limits, we may not be able to fulfill all COVID-related requests.)
Primary First Name*
Primary Last Name*
Agency*
Is this agency a non-profit organization?*
- No
- Yes
Address 1*
Address 2
City
State
Zip
Phone*
Fax
Email*
Type of Data Requested (please provide a detailed description of data needed)*
Purpose/Use of data (briefly describe how data will be used):*
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Data & Reports

Updated January 29, 2019, 9:40 AM

Measles cases are on the rise globally and here in Illinois and Cook County we've seen an increase in measles cases as well. Two doses of the Measles, Mumps and Rubella (MMR) vaccine are 97% effective in preventing this highly contagious disease. Learn more.